Severity of bipolarity in hospitalized manic adolescents with history of stimulant or antidepressant treatment.

Soutullo CA, DelBello MP, Ochsner JE, McElroy SL, Taylor SA, Strakowski SM, Keck PE Jr.

University of Cincinnati, Department of Psychiatry, Biological Psychiatry and Psychotic and Bipolar Disorders Research Programs

PO Box 670559, 231 Bethesda Avenue, Cincinnati, OH 45267-0559, USA. csoutullo@unav.es

BACKGROUND: Childhood bipolarity (BP) and ADHD frequently co-occur, these children often receive stimulants. METHOD: We retrospectively evaluated 80 adolescents hospitalized with BP, manic or mixed, assessed severity of hospital course, and compared groups according to current/past stimulant or antidepressant treatment. RESULTS: Lifetime ADHD rate was 49%; 35% of patients had exposure to stimulants and 44% to antidepressants. Stimulant-exposed patients were younger than non-exposed (mean+/-S.D.=13.7+/-2 vs. 15.1+/-2 years, Z=-3.1, P=0.002). Only stimulant exposure was associated with worse hospitalization course (MANCOVA, Wilks' Lambda=0.87, F=3.4; df=70; P=0.02). CONCLUSION: Stimulant-exposed BP-adolescents may have more severe illness course not fully explained by ADHD comorbidity. LIMITATIONS: Retrospective methodology and lack of structured interviewing make it difficult to quantify exposure to stimulants and antidepressants. Copright 2002 Elsevier Science BV.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12128245&query_hl=1&itool=pubmed_DocSum